Analysis of Growth During Prepubertal Years in Long-term Survivors After Pediatric Orthotopic Liver Transplantation

Abstract

Growth after pediatric liver transplantation (LT) has been the subject of reviews. The conclusions have not been consistent. To describe post-LT growth patterns in prepubertal liver transplant recipients and identify variables affecting their growth. Sixty-seven prepubertal transplant recipients met the inclusion criteria. Variables assessed were age, sex, pretransplant lack of growth, type of transplantation, primary diagnosis, liver and kidney function at one year post-LT, complications and retransplantation, prednisone therapy duration, allograft rejection episodes during the first year, cholesterol, triglycerides and immunosuppressive regimen. Mean follow-up was 3.5 years (range: 2-6 years). Growth according to baseline z-score, indications for transplantation and steroid withdrawal showed significant differences at 2 years post-LT. The causes of poorest z-scores in height post-LT were: height z-scores under -2.0 at transplantation, metabolic diagnosis, and use of steroids beyond 1 year post-LT.